title: Combination of high-sensitivity C-reactive protein and homocysteine predicts the short-term outcomes of Chinese patients with acute ischemic stroke.
abstract: BACKGROUND
  Ischemic stroke is one of the most common causes of death worldwide. Early and accurate prediction of outcome in acute ischemic stroke (AIS) is important and influences risk-optimized therapeutic strategies. We investigated the changes in high-sensitivity C-reactive protein (Hs-CRP) and homocysteine (HCY) levels, two of the risk factors, during the acute period of AIS and evaluated the relationship between these levels and short-term prognosis.
  
  
  METHODS
  We prospectively studied 189 patients with AIS who were admitted within 24 hours after the onset of symptoms. Serum Hs-CRP, HCY levels, and National Institutes of Health Stroke Scale (NIHSS) were measured at the time of admission. Short-term functional outcome was measured by the modified Rankin scale (mRS), 90 days after admission.
  
  
  RESULTS
  The median serum Hs-CRP and HCY levels were significantly higher in AIS patients as compared to normal controls (P < 0.0001, respectively). High-sensitivity C-reactive protein and HCY were independent prognostic markers of functional outcome and death (adjusted for age and the NIHSS) in patients with AIS. In receiver operating characteristic curve analysis, the prognostic accuracy of the combined model (HCY and Hs-CRP) was higher compared to all measured biomarkers individually and the NIHSS score.
  
  
  CONCLUSIONS
  High-sensitivity C-reactive protein and HCY are independent predictors of short-term outcome and mortality after AIS. The combined model may provide additional general prognostic information.
authors.affiliation: China Rehabilitation Research Center, Beijing, P. R. China.
authors.forename: Wen-Jun
authors.initials: WJ
authors.lastname: Tu
authors.forename: Sheng-Jie
authors.initials: SJ
authors.lastname: Zhao
authors.forename: Tong-Gang
authors.initials: TG
authors.lastname: Liu
authors.forename: De-Gang
authors.initials: DG
authors.lastname: Yang
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
mesh_terms: D000368:Aged; D044466:Asian People; D001921:Brain / Q000473:pathology; D002545:Brain Ischemia / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D006710:Homocysteine / Q000097:blood*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D012372:ROC Curve; D012720:Severity of Illness Index; D020521:Stroke / Q000097:blood* / Q000175:diagnosis* / Q000401:mortality
chemical_list: D006710:Homocysteine; D002097:C-Reactive Protein